In this final year of the grant we expect to complete analysis of the second data collection and the objective outcome study. In July-August, 1977, the logging for the third data collection from the five participating sites will take place. Sampling of the cases will occur in September and data collection will occur from October, 1977, to February, 1978. We plan to collect data from approximately 4,300 cases in eight diagnostic categories. The remainder of the 04 year will be spent in analysis, first of the 3rd data collection and then in correlating the observed changes in physician performance with the planned and unplanned change activities which occurred in the course of the three years subseqent to the first data collection. The final report will detail the findings of the quality of ambulatory medical care in five sites in Southeast Michigan. The measures of quality will be by pre-determined criteria applied to the recorded medical care in 10 diagnostic categories. The change in physician performance in response to a variety of planned interventions will be documented and related in as quantitative manner as possible to the various intensity and duration of the interventions.